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Xrayser: Change supervision legislation to make me a dispensing doctor

"There are already very profitable, successful dispensing businesses where the clinician is in charge"

Xrayser gives his own take on the recent revelations about changes to pharmacy supervision law

I have a confession to make. I no longer want to be a dispensing chemist.

This archaic expression still used by over 50 pharmacies in England projects the traditional image of the apothecary compounding a trusted nostrum, but that’s not what we do.

After an intense four-year degree course and another year’s practical clinical experience, what we pharmacy professionals do in the 21st century is initial labels on tubes of emollient and oversee the sale of 32 paracetamol tablets.

“Hang about!” I hear you cry. “There’s so much more to our job than that. We are the final safety check, the clinical surety that guarantees protection of the public.” Yes, I agree wholeheartedly. Pharmacies must be the place for patients and public to be sold or supplied medicines, and a pharmacist must always be present.

“And another thing,” I hear you ask, “what about local and advanced services?” And you’d be right, because we’ve agreed time and again that services are the way forward for pharmacy and, despite the myopic pronouncements of England's chief pharmaceutical officer, we have embraced service provision as much as we can.

The problem is that we have reached the limit, and that limit is the pharmacist.

As I’m passed a signed medicines use review consent form, I look up from the dispensary to see two patients waiting for the pharmacist and an anxious looking teenage girl needing emergency hormonal contraception.

The next item requires a new medicine service consultation, but first there are two buprenorphine scripts to supervise, and when I finally emerge from the consultation room it’s lunchtime and there’s a queue of waiting scripts to be checked, which I prioritise by searching for the one for the children screaming loudly and pretending the walking sticks are light-sabres. And in addition to all of that I am now doing 20 flu jabs a day.

To transition from dispensing chemist to clinical service pharmacist I don’t need to be able to leave the pharmacy, I need changes to supervision legislation to leave the dispensary. Yes, C+D's editor was right to ask about the lack of sector-wide consultation, because changes to supervision rules risk bitterly dividing our profession. It’s great that Community Pharmacy Scotland get the idea, but actually someone beat them to it.

There are already very profitable, successful dispensing businesses where the clinician in charge, has little or no involvement in the dispensing process, but must be present and responsible.

The dispensers and technicians have managed for decades to safely and effectively provide prescribed medication to patients without direct supervision, while the clinician is seeing patients in the consultation room.

That is the model that we should adopt – where a trained, registered healthcare professional can initial labels on tubes of emollient and oversee the sale of 32 paracetamol tablets, while I’m in my consulting room. But I would always be on the premises, to address the complex clinical scripts, brought to me under a strict and effective protocol.

I don’t want to be a dispensing chemist. I want to be a dispensing doctor.

6 Comments

Yo Palumeri, Community pharmacist

surely you should employ a second pharmacist. problems solved

A Hussain, Senior Management

The only person so far to get me to even consider these proposals as anything other than an awful move for patients and pharmacists.  But Xrayser is in a dangerous position as it appears that Steve Churton agrees with him!!

I can see only one way that the big boys will utilise such a rule.  Less pharmacist hours and increased pressure to squeeze every last drop out of services in those reduced hours.

Dispensing Doctors also get double the item fee, so that would be appreciated too!

janet revers, Community pharmacist

I agree with matt. I think the situation you envisage is the ideal and I think that is the way the proposals will be packaged . I do NOT believe this will occur in practice. As soon as any decision  is made to de-link supervision from the pharmacist  then the corporations will take full advantage,  The adavanced services are probably not profitable enough to support an extra wage especially the pharmacists (reduced though they now are)

Clare Moody,

Thank you Xrayser for addressing the elephant in the room.

Matt G, Community pharmacist

Good read. The proposal should in theory be something all pharmacists want, more time for patient contact, which will ultimatley help improve our relationship and respect/ standing within the community. The fear I see alot of my colleagues having however, is the fact that the big boys will be licking their lips at the thought of being able to shed a load of staff. Hopefully the changes are more in line with your model!

Ilove Pharmacy, Non Pharmacist Branch Manager

Most of you lot fell for the lie about 'services' 

This is the result.

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